LKnative – Ilioinguinal & iliohypogastric nerve block

Indications

Open hernia repair

Laparoscopic hernia repair

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Anatomy of the iliohypogastric nerve

The iliohypogastric (IH) nerve emerges at the lateral margin of the psoas major – typically together with the ilioinguinal (II) nerve

The IH descends across the anterior surface of the quadratus lumborum and it pierces the posterior aponeurotic extension of the transverse abdominis; it runs along and on top of the iliac crest sandwiched between the transversus abdominis and internal oblique. It innervates the inferior portions of these two muscles

The lateral cutaneous branch innervates the iliac crest and the skin of the hip between the iliac crest and the greater trochanter

The IH/II nerve block does not anaesthetize the lateral cutaneous branch of the IH nerve

The anterior cutaneous branch pierces the anterior aponeurotic extension of the external oblique muscle and innervates the skin above the medial part of the inguinal ligament